Objective To investigate the efficacy and safety of CT-guided radioactive 125I seed implantation(ISI)for blocking celiac plexus in the treatment of refractory abdominal cancerous pain.Methods The clinical data of 60 patients with refractory cancerous pain caused by abdominal malignancies(visual analogue scale score ≥4 points)were retrospectively analyzed.Patients of group A(n=29)received anhydrous ethanol injection treatment and patients of group B(n=29)received ISI treatment.The primary endpoints were pain score(visual analogue scale,VAS),daily morphine consumption(DMC),and local tumor control(LTC)rate.Secondary endpoints included the success rate of the procedure and postoperative complications.Results The technical success rate of surgery was 100％in both groups,and no serious complications occurred after surgery.The VAS pain scores in both groups showed a continuous decline from 1 to 8 weeks after surgery,but the difference was not statistically significant.However,the VAS scores in group A was significantly increased at T8 to T12 weeks(P＜0.01).In contrast,the pain relief time in group B remained stable until T16 to T24 weeks when an increase in pain improvement was observed.At T8 week,the LTC rate in group B was significantly better than that in group A,and the difference was statistically significant(P＜0.01).Conclusion Celiac plexus block with ISI can effectively alleviate the refractory cancerous pain caused by abdominal tumors.Compared with anhydrous ethanol injection,ISI has a longer pain relief time(up to T16-T24 weeks)and can effectively control the growth of local tumor,which is worthy of clinical promotion and application.

Objective To explore the effect of sorafenib on HeLa cell proliferation by inducing cell apoptosis and autophagy and its impact on drug resistance.Methods The drug-resistant cell strains were constructed through in-termittent induction method,with concentrations of 0,2.5,5.0,7.5,10.0,15.0,20.0 μmol/L.HeLa cells were incubated with increasing concentrations of sorafenib with each concentration for 1 week.The drug-resistant cell strains with stable passages were collected.MTT assay was used to detect the effect of sorafenib on cell prolifer-ation.Cell cycle distribution was analyzed by flow cytometry.The change in the expression of drug-resistant and ap-optotic genes in the parents and drug-resistant cell strains under different drug concentrations was examined by semi-quantitative PCR.The changes of apoptotic related marker proteins LC3-Ⅰ and LC3-Ⅱ were detected by Westernblot.Results Stable drug-resistant strains were successfully obtained;Drug-treated cells were more blocked in the G1 phase.In drug-resistant cells,the expression of apoptosis suppressor gene Bcl-2 was significantly decreased and the apoptotic gene Bax as well as the drug-resistant genes were all significantly increased(P＜0.05).The LC3-Ⅱ/LC3-Ⅰ ratio of drug-resistant cells was significantly higher than that of parent cells(P＜0.05).Conclusions Sorafenib may block the cell cycle,suppress malignant cell proliferation and promote autophage.On one hand,autophagy participates in the development of cell drug resistance and promotes cell survival.On the other hand,drug-induced autophagy may activate some of apoptotic signaling pathway in drug-resistant cells and promote the reversal of cell drug resistance.

The etiology of hemophagocytic lymphohistiocytosis (HLH) is complicated and difficult to diagnose, unexplained HLH often with hematological malignancies. Invasive biopsy can help to find etiology, the results may be affected by the technique and the location of the puncture site. Multiangle puncture can improve the success rate, but the corresponding risk increases. A patient with HLH was admitted to Affiliated Hospital of Zunyi Medical College. The etiology was unknown. Active symptomatic support treatment was conducted, at the same time, finding the evidence of viral infection, autoimmune disease related detection, blood culture, bone marrow puncture smear and spleen biopsy were performed respectively to find the pathogen basis. Spleen hemorrhage was not being controlled after spleen biopsy in patients, and emergency splenectomy was adopted to stop bleeding for saving lives. Finally, the patients died of low protein, pulmonary edema and respiratory failure. The bone marrow puncture and spleen biopsy failed to provide the basis for tumor invasion, while the spleen pathological slices plus immunohistochemical indicate diffuse large B cell lymphoma (DLBCL) after splenectomy, which was identified as malignant tumor-associated hemophagocytic syndrome. Underscoring the high risk of bleeding after tumor-associated splenomegaly puncture and the importance of having emergency plans. Through analyzing the clinical characteristics, diagnosis and treatment of this patient, we hope to improve the clinicians' understanding of HLH and lymphoma.